Non-physician Clinicians - A Gain for Physicians' Working in Sub-Saharan Africa Comment on "Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians".

Delanyo Dovlo,Ibiso Ivy King-Harry,Kevin Ousman

doi:10.15171/ijhpm.2016.110

Abstract

The changing demands on the health sectors in low- and middle-income countries especially sub-Saharan African countries continue to challenge efforts to address critical shortages of the health workforce. Addressing these challenges have led to the evolution of "non-physician clinicians" (NPCs), that assume some physician roles and thus mitigate the continuing shortage of doctors in these countries. While it is agreed that changes are needed in physicians’ roles and their training as part of the new continuum of care that includes NPCs, we disagree that such training should be geared solely at ensuring physicians dominated health systems. Discussions on the workforce models to suit low-income countries must avoid an endorsement of a culture of physician focused health systems as the only model for sub-Saharan Africa (SSA). It is also essential that training for NPCs be harmonized with that of physicians to clarify the technical roles of both.

Highlights

Government budget constraints meant NPCs were cheaper to train as the article indicates and they filled persistent gaps in health workforce needs caused by perennial lack of funding for their employment and their loss through their recruitment by richer countries
As with all health cadres, for NPCs to be effective, much emphasis should be placed on allocation of resources for their training and retraining as this is shown to improve healthcare.[17]
Being a doctor should not “genetically” give leadership and dominance over every cadre and the authors have correctly noted that “integrated and interdependent health service delivery chains are an imperative everywhere”; they say that “but in SSA, they take on a special importance” without explaining why this is especially so.[8]

Summary

Introduction

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Results

Conclusion